Optical

What is covered under Optical?

Optical covers eyewear, including:

• contact lenses. 
• prescription lenses
• spectacle frames
• prescription sunglasses.

You would usually buy Optical eyewear after consultation with an Optometrist.

Is Optometry a regulated profession in Australia?

Yes. In Australia, the Australian Health Practitioner Regulation Agency (Ahpra) and the Optometry Board of Australia regulate Optometry.

Does Medicare cover Optical (glasses and contact lenses)?

No. Medicare does not cover the cost of Optical (glasses and contact lenses). 

Does private health insurance cover Optical (glasses and contact lenses)?

If your private health insurance covers Optical (glasses and contact lenses), it falls under Extras Cover.

Ask your insurer whether it covers Optical. 

If so, check whether Optical is subject to:

• a waiting period before you can make a claim
• annual limits
• per person limits 
• per policy limits.

Does private health insurance cover consultations with an Optometrist?

No. Private health insurance usually does not cover consultations with an Optometrist.

Does Medicare cover consultations with an Optometrist?

Medicare usually covers eye tests with an Optometrist.

How often you can claim under Medicare depends on your age:

• If you are under 65, you can claim a Medicare Benefit for an eye test once every 3 years.
• If you are over 65, you can claim a Medicare Benefit for an eye test once every 12 months.

Medicare may also cover Optometry for the diagnosis and treatment of a developmental disorder or other disability for children under 13.

Medicare does not cover:

• more specialised eye tests
• consultations for:
  • contact lenses
  • visual fields
  • dry eye
• Digital Retinal Photography.

Does private health insurance cover Eye Therapy (Orthoptics)?  

If your private health insurance covers Eye Therapy (Orthoptics), it falls under Extras Cover.

Ask your insurer whether it covers Eye Therapy (Orthoptics).

Does private health insurance cover in-hospital eye treatments?

If your private health insurance covers in-hospital eye treatments, it falls under Hospital Cover for a range of conditions, including:

• cataracts
• eye infections
• glaucoma
• macular degeneration
• medically managed trauma to the eye
• tear duct conditions.

Ask your insurer whether you are covered for in-hospital eye treatments and cataract removal.

Compare Extras Cover from every private health insurer in Australia

Use our healthslips.com.au Calculator to find the best Extras Cover for you.